Provider Demographics
NPI:1225342587
Name:LYNDE, DAWN F (RPH)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:F
Last Name:LYNDE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1415
Mailing Address - Country:US
Mailing Address - Phone:207-989-6238
Mailing Address - Fax:207-989-3267
Practice Address - Street 1:422 WILSON ST
Practice Address - Street 2:
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1415
Practice Address - Country:US
Practice Address - Phone:207-989-6238
Practice Address - Fax:207-989-3267
Is Sole Proprietor?:No
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR4553183500000X
MA21814183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist